Ectopic pregnancy is a common emergency and critical disease in obstetrics and gynecology. Its diagnosis and treatment face multiple challenges. At present, early diagnosis is still difficult. Asymptomatic patients have high risk of missed diagnosis.There is controversy over the threshold for dynamic monitoring of β-human chorionic gonadotropin (β-hCG). Ultrasound has low sensitivity for unruptured lesions, resulting in a delay to the rupture stage in approximately 40% of cases. These increase the risks of fertilitydamage and even life-threatening situations. When formulating a treatment plan, it is necessary to comprehensively consider factorssuch as the patient's fertility needs, age and comorbidities, and to strike a balance between conservative drug treatment and surgicaltreatment. This article systematically reviews the difficulties in the diagnosis and treatment process and proposes a stratified diagnosisand treatment system based on evidence-based medicine. Our aim is to break through the limitations of traditional diagnostic and treatment models, achieve the diagnosis and treatment goals of precision, minimally invasive treatment and fertility preservation. It will provide new ideas for clinical practice.